TRVCC TRACK Online Registration Grades 2-5

Primary Parent/Guardian Contact Information

Country*
Email*
Confirm Email*
Phone*
Mother Name / Phone Number / Address*
Father Name / Phone Number / Address*
Child 1 Name, Gender, Age, Grade*
Child 2 Name, Gender, Age, Grade
Emergency Contacts (that are not parents) Two Contacts required. Names, addresses and phone numbers*
Would the above contacts be allowed to pick up your child from TRACK program?
  • Yes
  • No
Doctor's Name & Phone Number*
Health and Emergency information: List any health conditions such as heart disease, diabetes, epilepsy, serve allergies, etc. If your child uses medications, please indicate.

Registration Fees

Days your child will be attending TRACK (check all days that apply)*
  • Monday
  • Tuesday
  • Wednesday
  • Thursday

Adjust quantity by the number of days you check. For example, if you want your child to attend Monday and Tuesday, quantity number will be 2.

Quantity
Price
Total
Daily Fees - Member
X
$
4.00=
$
0

Track Monthly Fees - Member
X
$
30.00=
$
0

TRACK Daily Fees Non-Member
X
$
5.00=
$
0

TRACK Montly Fees Non-Member
X
$
45.00=
$
0

Final Total:
$
0

Parent Authorization: By Signing I have read and understand all TRVCC/TRCP TRACK policies.  I give permission and authorize the person in charge to take emergency medical action if needed, take my child on field trips when presented, and give my permission to take photos and use in TRVCC/TRCP media releases.  By signing I also I voluntarily assume all risks associated with my use and my child’s use of the Community Center, TRE and TRCP.  I unconditionally release, hold harmless and indemnify Tongue River Valley Community Center, its directors, employees, and representatives, the owner of the building premises, and all other persons from all claims of any kind, in law or in equity, including but not limited to death, bodily injury or property damage, related to or resulting from any activity engaged in by me or my child at the Community Center, TRE, and TRCP. 

Waiver Acknowledgement*

Payment Information

Amount*
$
Payment Type
We only accept credit/debit card payments. After you complete this form, select Submit to enter your card details into our secure transaction processor. Your submission will be processed when you finalize your secure payment information.

Additional Comments?

Additional Comments
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